Conscious Adult Choking

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Now let's cover the highly effect and very
important skill called conscious adult choking.

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Now in this scenario we have someone who is
eating at a table, they begin to choke, we

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know they were choking because they could
not cough, they could not breathe, they could

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not speak. This is a full obstruction if and
it need's help if it's gonna come out in most

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cases. If it's easy to activate the emergency
response team or call 911, great, but if not,

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we can wait until the patient goes unresponsive
before we actually take the time to call 911

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or activate a code. But in this case we're
gonna come up to the person, we're gonna look

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them in the eyes, "Are you choking"? They
nod "Yes". "I know how to help you. May I

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help you". They give me permission to help
them. They're still conscious and so we wanna

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get that permission from the patient if at
all possible. Now I'm gonna elevate their

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elbows, I'm gonna find the belly button. The
belly button is my landmark so that I can

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tuck my thumb in and put the fist just above
the belly button on their abdomen. I wanna

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stay below the xiphoid process which is approximately
right here, I wanna stay just above the belly

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button because this is where i find the diaphragmatic
region. This is exactly what I want so that

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I can bring that diaphragm up and in while
I compress the lower lobes of the lung, shoot

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the air up the trachea, popping that object
out, and it's effective the majority of the

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time. So I'm gonna take that hand, keep my
elbows out so I'm not on their ribs anymore

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than I have to be, and I'm gonna start with
my inward and upward thrust. And I'm gonna

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do these thrust, until either the object comes
out or the person goes unresponsive. In this

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case the object did come out. He began breathing,
coughing, clearing his own airways. I simply

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re-encourage him that he's doing fine. If
he feels like sitting down you can have him

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sit down. And if we had not already called
911, now would be the time to call 911 or

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call a code "if" they go unresponsive. If
we've already called 911 keep 'em coming,

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it's fine. Even though the object already
came out, it's always a good idea to have

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EMS stay on the way, so that if this person
opts not to go in, they can be checked out

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by the EMS professionals. They're gonna check
airway, they're gonna check some lung sounds

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to make sure there's no partial obstruction,
and they're probably do a quick assessment

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to make sure there is no internal bleeding
from the abdominal thrust. So if the individual

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does not opt to have that done to him, or
the EMS providers do not come, I always like

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to encourage them to go to their own practitioner
and just be looked over and made sure that

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everything is okay. Keep in mind, that if
this person were not to have this successful

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removal of the obstruction, they would probably
go unresponsive in a short amount of time.

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And it's then that we would assist them to
the ground carefully and begin the skill of

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unconscious adult choking. Now we're gonna
talk about special considerations as it relates

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to a pregnant woman. You know when we're doing
this lifesaving skill of trying to remove

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the obstruction from the airway, and the person
is pregnant, we need to understand that we're

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dealing with two patients, save mom, save
baby. So it's important that we're aggressive

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in our treatment, but there's a special way
to do it so that we don't injure the baby

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in the process. Let's take a look at how we
do that right now. When we have the, the person

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in front of us, we know the baby is here in
the normal location where we would do abdominal

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thrust. So we're gonna avoid the area altogether
by forming the fist and going under the breast

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with that fist on the sternum. We're then
gonna take that opposite hand, go under the

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breast and onto that fist that's on the sternum.
We're now gonna do inward thrusts, inward

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deep thrusts. And we're gonna continue to
do those compressions until the object comes

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out and the person begins to breathe normally
again. If they doesn't come out, they're gonna

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go unconscious. When they go unconscious,
we're gonna activate 911, and then we're gonna

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start doing our unconscious choking victim
compressions as we learned in the other segment.